Friday, July 31, 2009

Health Care Reform and YOU

Right now there is a lot happening in Washington, DC that will have a direct effect on you. Especially if you are a breast cancer patient/survivor.
Whether you are a democrat or a republican or an independent, whether you voted for our president or not, you must know what is in this bill.

It stands at 1,018 pages right now. Ninety-nine percent of our representatives, who we voted into office to be our voices, have not even read it.

There are facts and there are muddled messages being told.

I will start by posting a couple of articles that will illuminate what we may be facing.

On a personal note, as a single payer with private insurance, and with the pre-existing condition of cancer, I am scared to death of what will happen to me.
From what I have discovered, the version being debated right now, will alter my medical care forever.

From the NEW YORK POST

July 17, 2009 - President Obama promises that "if you like your health plan, you can keep it," even after he reforms our health-care system. That's untrue. The bills now before Congress would force you to switch to a managed-care plan with limits on your access to specialists and tests.

Two main bills are being rushed through Congress with the goal of combining them into a finished product by August. Under either, a new government bureaucracy will select health plans that it considers in your best interest, and you will have to enroll in one of these "qualified plans." If you now get your plan through work, your employer has a five-year "grace period" to switch you into a qualified plan. If you buy your own insurance, you'll have less time.

And as soon as anything changes in your contract -- such as a change in copays or deductibles, which many insurers change every year -- you'll have to move into a qualified plan instead (House bill, p. 16-17).

When you file your taxes, if you can't prove to the IRS that you are in a qualified plan, you'll be fined thousands of dollars -- as much as the average cost of a health plan for your family size -- and then automatically enrolled in a randomly selected plan (House bill, p. 167-168).

It's one thing to require that people getting government assistance tolerate managed care, but the legislation limits you to a managed-care plan even if you and your employer are footing the bill (Senate bill, p. 57-58). The goal is to reduce everyone's consumption of health care and to ensure that people have the same health-care experience, regardless of ability to pay.

Nowhere does the legislation say how much health plans will cost, but a family of four is eligible for some government assistance until their household income reaches $88,000 (House bill, p. 137). If you earn more than that, you'll have to pay the cost no matter how high it goes.

The price tag for this legislation is a whopping $1.04 trillion to $1.6 trillion (Congressional Budget Office estimates). Half of the tab comes from tax increases on individuals earning $280,000 or more, and these new taxes will double in 2012 unless savings exceed predicted costs (House bill, p. 199). The rest of the cost is paid for by cutting seniors' health benefits under Medicare.

There's plenty of waste in Medicare, but the Congressional Budget Office estimates only 1 percent of the savings under the legislation will be from curbing waste, fraud and abuse. That means the rest will likely come from reducing what patients get.

One troubling provision of the House bill compels seniors to submit to a counseling session every five years (and more often if they become sick or go into a nursing home) about alternatives for end-of-life care (House bill, p. 425-430). The sessions cover highly sensitive matters such as whether to receive antibiotics and "the use of artificially administered nutrition and hydration."

This mandate invites abuse, and seniors could easily be pushed to refuse care. Do we really want government involved in such deeply personal issues?

Shockingly, only a portion of the money accumulated from slashing senior benefits and raising taxes goes to pay for covering the uninsured. The Senate bill allocates huge sums to "community transformation grants," home visits for expectant families, services for migrant workers -- and the creation of dozens of new government councils, programs and advisory boards slipped into the last 500 pages.

The most recent ABC News/Washington Post poll (June 21) finds that 83 percent of Americans are very satisfied or somewhat satisfied with the quality of their health care, and 81 percent are similarly satisfied with their health insurance.

They have good reason to be. If you're diagnosed with cancer, you have a better chance of surviving it in the United States than anywhere else, according to the Concord Five Continent Study. And the World Health Organization ranked the United States No. 1 out of 191 countries for being responsive to patients' needs, including providing timely treatments and a choice of doctors.

Congress should pursue less radical ways to cover the uninsured. We have too much to lose with this legislation.

Betsy McCaughey is founder of the Committee to Reduce Infection Deaths and a former lieutenant governor of New York. betsy@hospitalinfection.org


From the WALL STREET JOURNAL:

Health Reform and Cancer

The danger is that ObamaCare will stifle

Medical innovations that could save patients like me.


JULY 31, 2009 I have been battling non-Hodgkin’s lymphoma, an incurable blood cancer, for the past nine years. Last year, I was also diagnosed with uterine cancer.

I didn’t run to Canada for treatment. Medicare took care of my needs right here in New York City. To endure, I just need the freedom to choose my insurance, my doctors, and get the diagnostic scans and care I need. And one more thing: I need hope that a treatment will be developed that can control my diseases the way insulin controls diabetes.

Every cancer patient needs these things, especially hope. But the government’s plan to reform the health-care system in this country threatens all of this—particularly the development of new treatments.

When I was first diagnosed in 2000 I had chemotherapy. It put me in remission, but nearly killed me.

Three years later the lymphoma was back and I faced more chemo. This is so often the pattern of cancer: recurring disease and repeated chemo. In the end patients often die not from the disease, but from the treatments.

I took a different path, seeking a cancer vaccine. One had been developed at Stanford University 12 years earlier that had given 90% of patients very long remissions and cured some entirely. Unlike chemotherapy, there were no severe side effects.

But I couldn’t get the vaccine because the Food and Drug Administration required another trial that would take nine more years. Over-regulation has kept this treatment from patients for 21 years, as some 24,000 lymphoma patients died each year.

My husband and I searched the Internet and found another vaccine being tested at Freiburg University in Germany. That vaccine has helped me avoid chemotherapy for years. My oncologist says he’s never seen another patient do so well with the type of lymphoma I have.

I am still here because my care was managed by doctors—not a government agency. My doctors do what the bureaucracy can’t: They see me as a human being.

Patient-as-person will be a lost concept under the new health-care plan, where treatments will be based not upon individual patient needs, but upon what’s best for everyone. So cancer drugs for seniors might take second place to jungle gyms and farmers’ markets—so-called preventive care—which are covered under both the House and Senate versions of the health bill.

The stimulus package passed earlier this year allocated $1.1 billion for hundreds of “Comparative Effectiveness Research” studies. This project will compare all treatment options for a host of diseases in order to develop a database to guide doctors’ decisions. Research of this sort typically takes years. But the data will likely be hastily drawn conclusions that reflect the view of the government agencies that fund the studies: Cheap therapies are just as good as expensive ones.

In order to finance health-care reform, Democrats in Congress have proposed cutting $500 billion from Medicare over the next 10 years. Yet in his press conference last Wednesday, President Barack Obama denied that Medicare benefits would be cut. He has surrounded himself with advisers who believe otherwise.

Tom Daschle, Mr. Obama’s original pick to head Health and Human Services, argues in his book “Critical: What We Can Do About the Health-Care Crisis,” that we should accept “hopeless diagnoses” and “forgo experimental treatments.” Mr. Daschle blames the “use and overuse of new technologies and treatments” for runaway health-care costs. He suggests a Federal Health Board modeled after the British “NICE” board to make decisions on health-care rationing.

But the British system is infamous for denying state-of-the-art drugs to cancer patients. Thus cancer-survival rates in Britain are far below those in America, just as they are in Canada.

Canadian cancer patients told to wait months for treatment and diagnostic scans frequently go south and pay out-of-pocket for care in the United States. A number of Quebeckers even sued their government for violating their “right to life and security” under the Quebec Charter of Rights and Freedoms. Canada’s Supreme Court has acknowledged the pervasive rationing that occurs. In the 2005 case Chaoulli v. Quebec (Attorney General) , the majority opinion stated: “The evidence in this case shows that delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care.”

Despite such evidence, the Obama plan is likely to target various treatments—including radiology scans—in order to cut costs. I survived this long because my radiologist examines each of my scans with me in detail.

One of those scans also saved my life by picking up unsuspected uterine cancer. The congressional majority seems blissfully unaware that all cancer patients need those scans to monitor their diseases.

Also uneasy with the cost of medical progress is Dr. David Blumenthal, Mr. Obama’s new head of Health Information Technology. It is not reassuring that he stresses that two-thirds of the annual increases in health spending result from medical innovation, as he has written in The New England Journal of Medicine.

Cancer patients need nothing more than such innovation. Yes, developing more effective, less toxic treatments is expensive. The prices of new cancer therapies reflect the billion-dollar cost of developing each new drug. But such treatments can be life-saving, as they have been for me.

Despite its warts, our system works. Carelessly tinkering with it will have a world-wide penalty—the stifling of new drug development. What company would spend a billion dollars to develop a drug that will not be reimbursed by the new health plan? This would be a direct, devastating blow to the most vulnerable Americans.

In spite of the president’s assurances, there is every sign that this plan will be financed by deep cuts to Medicare, which, like the public option, will limit payments for specialists, radiology scans, and cutting-edge cancer drugs. These are prime targets because they are more expensive than other services. But are we really expected to forgo new medical technology and return to the cancer care of the 1970s?

When members of Congress are asked if they will opt for the public plan, they say no. That’s for the rest of us.

The number of Americans who have cancer exceeds 10 million. It’s time for cancer patients and their families to remind those on Capitol Hill that health-care reform is a matter of life and death for us.


2 comments:

kareylou said...

As a breast cancer patient, I understand that it's scary to contemplate changing our health care system when we are in the midst of being treated for a life-threatening disease. But for every scary anecdote about people who may be denied care under a reformed system, there are actual stories of people who are dying after being denied care by insurance companies.
I was in Wise County Virginia last weekend, where nearly 3000 people lined up as well as they could for free medical care, some waiting outdoors for up to two days. Many were unemployed, or single parents who had gotten sick and then been dropped by their insurance carriers. No matter how well my insurance plan is working for me, I can't look at that and say let's keep the status quo. It is a moral atrocity.
There has got to be a way, in America, to provide a basic level of health care to all of our citizens. I believe that is the right thing to do, and I believe that it is not happening under our current system. So I'm actually glad to see the problem finally being acknowledged and addressed, although I admit to some anxiety about my own personal situation. I have been in contact with my representatives and have given them a lot of input.
Thanks Gina for all you do for the breast cancer community. You are a treasure.

p.s. I don't believe anything I read in the New York Post, which is considered a tabloid. And the Wall Street Journal represents, well, Wall Street. I try to get my political news from C-Span, which is pretty much unfiltered and unspun.

kareylou said...

p.s.s.
FactCheck.org has good articles about what is and is not in the health care bill currently being debated. Two that I looked at appeared on July 23 and July 29.